The study aimed to appraise and deepen the scientific understanding of adolescents self-reported self-esteem (SE) at age 1213 from a resource perspective and test its ability to predict subsequent perceived mental well-being (MWB) at age 17. SE was significantly negatively associated with perceived MWB, explaining 18 per cent of the variance in a hierarchical ANCOVA model, including initial MWB as a covariate. For every additional point on the SE scale at age 1213, adolescents rated their MWB at 17 years by 0.06 units less. Arguably, normal SE rather than high SE at 1213 years is predictive of later mental well-being. The negative correlation may also be connected to girls lower initial SE than boys. The association was not surprising, though earlier research has reported associations between self-esteem and mental disorders [18]. However, the association with mental well-being in adolescence is not well represented in previous research, and several researchers argue for exploring this dimension in mental health [12].
Girls often report more internalising mental health problems, and gender differences have previously been shown [19]. In this study, however, gender did not stand out as an independent predictor of MWB at age 17 as expected. However, when conducting the analysis separately for boys and girls, the association between SE, initial MWB, and MWB at age 17 was stronger for girls than for boys. When first controlling for initial perceived MWB, it affected girls by a variance of 13 per cent, while it affected boys by only 10 per cent. The association was inversely significant when using initial SE as a covariate; girls showed three times higher eta square than boys (15% vs. 5%). SE as a predictor of future MWB has a more significant impact on girls than boys: therefore, supporting girls with low SE might be one way to support their future well-being.
Mental well-being is important for boys as well. In a school-based survey in Norway, a similar result was found regarding self-esteem, gender, and life satisfaction, where girls reported lower SE and boys had higher quality of life [30]. In our study using MWB at age 1213 as a covariate in the model, initial MWB could explain four per cent of the variance and again SE three per cent of the variance in the model. When controlling for gender, female gender had a five per cent eta square effect on SE and only a two per cent effect on MWB. For boys, the situation was reversed (1% vs. 5%). One explanation could be that girls reported lower SE and MWB than boys. This reasoning aligns with results from a cohort study [15] following adolescents self-esteem and mental health during a school year. When these two estimates were combined, they highlighted the importance of handling questions like these from a gender perspective, especially in mental health. Low self-esteem for girls early in life and low mental well-being for boys need to be addressed.
In this study, self-esteem was stable with a slight decrease, while previous research has indicated that self-esteem increases with age [31]. However, four years may not be sufficient for this kind of assessment. Looking at the total samples SE, most adolescents had normal levels of SE. The prevalence of low self-esteem has been found twice as common in girls as in boys. Boys on the other hand more often had high self-esteem [20]. One explanation can be, as Agam et al. [32] explained in their study regarding gender roles in society and their influence on adolescents self-esteem, that it is not surprising that boys report higher self-esteem. Boys are more likely to be in situations encouraging power, excitement, competition, and conflict. Girls are more likely to encounter support, self-disclosure, and intimacy situations. Therefore, girls develop emotions related to internalising dimensions, while boys tend to build emotions related to externalising dimensions [32]. Global self-esteem, estimated by Rosenbergs self-esteem scale, is influenced by others values of the individual [33]. Changes are common in the identification period during adolescence, from childhood to adulthood [34]. This identification connects to self-concept or self-esteem, and the present study consists of persons in adolescence, from 1213 to 17 years of age. However, there is an ongoing debate on whether self-esteem is stable during a lifespan [35]. Kuster and Orth [36] found in their longitudinal lifelong follow-up study of participants aged 14 years and onwards that those with high self-esteem at a given time very likely also had high self-esteem one year later, as well as five, 10, and even 30 years later. These changes during adolescence also affected mental health, which is visible in our study. Regarding changes during adolescence, Patalay et al. [37] reported decreasing psychological well-being with increasing age, which may be an essential factor in social and academic stress and potentially affect self-esteem.
Thirty per cent of the adolescents with high self-esteem reported good mental well-being, while 16 per cent had low mental well-being. However, most had good mental well-being when looking at those with low self-esteem. However, in another study, boys seemed to have a higher mental well-being in both the young and older age groups [38]. A review [39] showed the complexity between self-esteem and mental health problems. Low self-esteem can predispose an adolescent to develop a poor mental well-being. Still, the opposite is also possible: Low self-esteem can be induced by poor mental well-being. In the review, eight out of the ten studies included low self-esteem in young people. It appears to be a relatively weak predictor of the development of anxiety and depression in later adolescence and young adulthood. On the other hand, adolescents with anxiety or depression disordersespecially those comorbid with these diagnoses, were likely to have low self-esteem. Kean and Loades [39] also found that adolescents with mental health problems had lower self-esteem than those without. This is in line with our longitudinal study, although most adolescents aged 1213 showed average self-esteem and normal scores of perceived mental well-being. This knowledge was already on the agenda in the 1950s when Jahoda [21] developed the connection between mental health and attitudes towards oneself. In recent years, positive psychology has been discussed more in research [12], but there are still difficulties in dealing with different meanings of concepts concerning mental health [40].
Global self-esteem is connected to psychological well-being [33], and this study sought to estimate positive predictors of mental health from a salutogenic perspective. Mental health concerns coping with and handling different stressors during a lifetime. From a salutogenic perspective, this means perceiving the situation also as meaningful [3]. Some previous studies have focused on outcomes that describe positive mental health. In the Canadian COMPASS study (n=74501) following students aged 12 to 19, Romano et al. [38] found a significant decrease in the mean of mental health (estimated by flourishing) from ninth to 12th grade (32.1431.29). Therefore, a specific outcome variable, perceived mental well-being (MWB), was created for the study. The intention was to create a variable covering mental well-being in line with Westerhof and Keyess mental health continuum [17], arguing for exploring the well-being dimension within mental health. The mental health continuum measures three aspects of mental well-being: emotional, psychological, and social well-being. Two variables in this study, How do you feel about life right now and I think my life has purpose and meaning relates to psychological well-being, and the question How healthy do you think you are? relates to emotional well-being. The created variable MWB does, in that sense, relate to mental well-being despite lacking a specific item measuring social well-being. The concept the variable refers to differs from subjective well-being, which usually focuses on quality of life [41] which again mostly focuses on happiness and life-satisfaction. In Keyes model, happiness, and life satisfaction relate primarly more to emotional well-being than the concept of mental well-being the present study does. The three questions applied in this study refer to a sense of health and purpose. Including a more psychological aspect of well-being does not only involve hedonistic but also eudaimonic aspects of well-being, and by that also a sense of purpose. While there is empirical evidence showing that happiness and life-satisfaction are associated [42] with better health this study focuses on mental well-being indicating that self-esteem affects mental health. The psychological dimension including purpose and meaning is a concrete perspective which is applicable in school to motivate adolescents to enhance their mental health.
A mothers educational level was significantly associated with initial SE and MWB for girls, which aligns with [43] findings on children and adolescents of mothers with low levels of education who had significantly more mental health problems. In our study, 60 per cent had mothers with post-secondary education. When controlling for the familys economy, there was a significant association with SE, especially in boys, in line with an earlier study [22]. The association with the mothers educational level was more dominant among girls.
In all longitudinal studies, participant drop-out is an almost inevitable event, and at the same time, a longitudinal study design is a strength. In this study, the total population of 1213-year-olds from four municipalities was invited, and the majority participated. However, in senior high school, at age 17, adolescents were more spread out and more difficult to contact, increasing the dropout rate. While 1472 participated in the first wave, only 779 participated in the fifth regarding SE vs. 1414 in the first wave and 746 in the fifth regarding mental well-being. Of these, only 654 responded to both waves and questionnaires. Looking at those participating in Wave 1 but not in Wave 5 vs. those participating in both, we see a somewhat higher attrition rate among boys. Regarding SE and MWB, a slight non-significant difference in the mean scores (p=.269 vs. p=.346) could be detected, pointing at a random dropout.
Another limitation is using data from already gathered survey responses (i.e., secondary analysis). The strength of obtaining ready-collected longitudinal data is hampered by what variables were included and when the data related to them were collected. An outcome variable had to be developed, which was not validated as a scale in other studies. Theoretically and also according to a statistical evaluation, these variables fit together. The questionnaire lacked a specific item measuring social well-being as the third aspect of the mental health continuum, which may, besides the regression to the mean phenomenon, have impacted the negative association between initial self-esteem and subsequent mental well-being in the ANCOVA models. However, when creating the variable, the aim was to assess similar content, as is the case concerning the well-validated scale health continuum created by Westerhof and Keyes [12]. Another aspect related to when data on SE was collected was that the data was available only from waves 1 and 5. However, a strength worth mentioning is the salutogenic approach to estimating predictors of positive mental health rather than identifying predictors of mental health problems or mental diagnoses, as most previous studies have done.
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